The Case Against Antidepressants

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Thanks for letting me log some stuff in your thread @FunkOdyssey . At this point I will probably start my own thread and appreciate all the input from you guys.

Lexapro currently beating the pants off my long term skepticism of SSRIs. Very early though, don't want to jinx it.
 
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I actually feel worse mentally the more I increase frequency of my trt. I was doing ok on 3x a week. I’ve tried daily’s a few times. And every time I do around week 2 I become a depressed mess. I also seem to get depressed more when my levels are too high. Just like when I use the transcrotal cream.
This is consistent with the idea that something about excessively high or excessively stable levels of T and related hormones is numbing or depressing. The forms of TRT most likely to avoid these symptoms IMO are:

  • Low/moderate doses of cypionate or enanthate injected once weekly
  • Low/moderate doses of cream. Once daily application might be preferable to twice daily.
  • Low/moderate doses of propionate injected ED or EOD
  • Jatenzo and similar orals
  • Natesto

That said do you think a trial of low dose ssri would be detrimental long term ? I feel like I did feel better overall on ssri. Even without trt. And my friend and wife say the same. But now I’m so worried about long term sides and becoming dependent on them. And them possibly making me worse off in the future.
It is hard to say. I don't know if you have maxed out your SSRI-induced propensity to depression already or if it can worsen further with additional use. I have done the same thing you did recently where I took a few doses of SSRI when I was at a low point and then changed my mind. I am biased against using them for depression and I am grateful that I managed to get through some tough spots without them. Whichever decision you make will be understandable though.
 
What’s funny is back in my early 20s I had crippling anxiety. And paxil legitimately cured my issues. I was on it for 2 years. Highest dose. I gained so much weight. I had a little delayed ejaculation. But libido was still great. I actually quit it cold turkey, didn’t know any better. And I never looked back. Had no side effects and anxiety was gone. I’m not sure if it actually did anything or the Placebo made me realize the panic wasn’t going to kill me and was able to not over think it.

then in my mid 30s I jumped on low dose lexapro. I used it because dr Mariano said it could help people with cortisol issues tolerate trt. I stayed on it for 4 years. i was only on 2.5 mg. Didn’t have any side effects. i Was mmostly off trt those 4 years. But when I finally committed to trt 6 months in I started to get some emotional flatness and thought maybe it was ssri. I got off the lexapro and had pretty annoying withdrawal. A lot of brain zaps and some depression. Took about 3 months for the acute symptoms to get better. Then slowly over the last year I’ve become more and more depressed on trt alone. Trt is great for my libido, nocturnal erections,glycemic control. But my moods and way of thinking about life are just off. I’ve been toying with the idea of going on low dose Prozac for some time. I even started it for a week and then bailed again. I’ve read a lot of the things @FunkOdyssey has posted and looked into them myself for years. part of the reason I got off them.

im not sure what to do but I have been absolutely miserable lately. I have admittedly Been messing with my trt way too much. And that does mess with my mental state. But I almost feel stuck like I need a reset. I’m not sure if I got here from the 4 year ssri use And withdrawal. Or the trt it self. I been off the ssri for little over 2 years. And on trt for same time.

sorry if my grammar and punctuation is off. Kids are screaming in the back round driving me nuts lol.
100% anecdotal thoughts here, but I suspect that part of the "feel good" with TRT relates to some kind of change from some kind of baseline. Then, if the baseline stabilizes, it becomes a new normal, and maybe you return to some kind of emotional flatness. I suspect this is a massive oversimplification of the matter. However, it this model is even remotely true, it makes Natesto attractive.

Disclaimer: I am not currently on Natesto, and looking back, I suspect I was slightly under treated on it. But, I do believe it was helpful for mood. I generally looked forward to my next dose. I think the periodic ups and downs were probably good for mood.

Food for thought.
 
Have you spent any time learning about any contemplative traditions? If not, I can give some thoughts.

Also, based one what I have been reading, I have legitimate hope in some of the new research in psyilocibin and related compounds.
Hey thanks for the offer. I have done some brief reading but what have you found beneficial?
 
I can very confidently state my perpetual and deeply entrenched depression over last 25 years was not related to SSRI use. I would have continued to trudge through if this anxiety / panic BS had not come knocking. That stuff is no joke.
 
Hey thanks for the offer. I have done some brief reading but what have you found beneficial?
First, I should say that I come from a Judeo-Christian background and have no formal training in theology or philosophy. But, over the last several years, I have done quite a bit of reading in Eastern approaches to understanding the human condition, and have found it pretty helpful.

I would say Vipassana concept has been useful. By grasping the concepts behind this style of thinking, you have the potential to reduce self-inflicted suffering. One of the things I have read is that some believe that Pain x Resistance = Suffering. We can't eliminate painful stimuli. It's part of life. But, by reducing resistance, or just by accepting certain things about the world and ourselves, we can reduce our suffering.

An example is the Second Arrow phenomenon. I don't remember the exact story, but has to do with a monk shot by an arrow. After being shot, he began to worry about the wound getting infected, bleeding and all sorts of consequences. Obviously, getting shot by an arrow hurts and can cause problems, but it was the worry itself that made the experience so painful. I think the lesson here is that equanimity, even towards your own human experience, can help you suffer less.

I have played with insight meditation as well as Transcendental Meditation (TM). They are different schools of thought with different potential benefits, but I believe there are overlapping benefits to the two techniques. I was formally trained in TM, and found it a nice technique, but got a bit turned off by the organization itself (I can expand if you want). Currently, I find myself using both techniques periodically. I can't say exactly what keeps drawing me to meditate, but I find myself wanting to do it on a regular basis. There are probably many reasons, but I think one of them is that it helps me stop rumination and what some refer to as default mode thinking. Don't get me wrong - I don't float above the floor when I meditate, and the moments of non-rumination (or present awareness) are extremely fleeting. But, somehow, I feel better having done it.

It has been a bit of a journey for me, and I believe it will continue to be. I enjoy reading others' thoughts on the contemplative traditions because I think reading a new perspective helps me get a deeper understanding of what is attractive about this way of thinking. One author describes Buddhist thought as being in the Matrix (blue pill, red pill). It forces you to learn that our current view of reality is heavily shaped and created by a whole bunch of mental constructs that may or may not have any real justifications. Realizing this can be liberating.

Anyway, that all may be way too philosophical for this forum! But if any of the above makes any modicum of sense to you, I can suggest a few things to read. I don't believe there is any one "bible" that fully elucidates all these concepts perfectly, but I think much of what I have read has hinted at various truths that have helped me deal with every day life.

A fun and pretty easy one to start with is called "Ten Percent Happier" by Dan Harris. I also really like a book called "Why Buddishm is True" Can't remember the author, but he is a professor at Princeton. I don't love the title (it feels too religious and can be off-putting, but the book is great). I have several others that were great. Feel free to DM me if you want more recommendations.
 
This is consistent with the idea that something about excessively high or excessively stable levels of T and related hormones is numbing or depressing. The forms of TRT most likely to avoid these symptoms IMO are:

  • Low/moderate doses of cypionate or enanthate injected once weekly
  • Low/moderate doses of cream. Once daily application might be preferable to twice daily.
  • Low/moderate doses of propionate injected ED or EOD
  • Jatenzo and similar orals
  • Natesto


It is hard to say. I don't know if you have maxed out your SSRI-induced propensity to depression already or if it can worsen further with additional use. I have done the same thing you did recently where I took a few doses of SSRI when I was at a low point and then changed my mind. I am biased against using them for depression and I am grateful that I managed to get through some tough spots without them. Whichever decision you make will be understandable though.
For me the ssri” seem” to give me the ability to tolerate higher levels of testosterone also. That’s another reason I was thinking about going back to them. At this current time I seem to feel better overall on lower doses (less side effects). But the positives are lower. When I move dose up. I get better libido And more motivated to work out. But also get some old “low cortisol“ symptoms back. i Don’t know if any of these things are what’s actually going on it could all be my perception of things based on what I’ve read over the years. Almost forming some sort of a conformation bias.
 
First, I should say that I come from a Judeo-Christian background and have no formal training in theology or philosophy. But, over the last several years, I have done quite a bit of reading in Eastern approaches to understanding the human condition, and have found it pretty helpful.

I would say Vipassana concept has been useful. By grasping the concepts behind this style of thinking, you have the potential to reduce self-inflicted suffering. One of the things I have read is that some believe that Pain x Resistance = Suffering. We can't eliminate painful stimuli. It's part of life. But, by reducing resistance, or just by accepting certain things about the world and ourselves, we can reduce our suffering.

An example is the Second Arrow phenomenon. I don't remember the exact story, but has to do with a monk shot by an arrow. After being shot, he began to worry about the wound getting infected, bleeding and all sorts of consequences. Obviously, getting shot by an arrow hurts and can cause problems, but it was the worry itself that made the experience so painful. I think the lesson here is that equanimity, even towards your own human experience, can help you suffer less.

I have played with insight meditation as well as Transcendental Meditation (TM). They are different schools of thought with different potential benefits, but I believe there are overlapping benefits to the two techniques. I was formally trained in TM, and found it a nice technique, but got a bit turned off by the organization itself (I can expand if you want). Currently, I find myself using both techniques periodically. I can't say exactly what keeps drawing me to meditate, but I find myself wanting to do it on a regular basis. There are probably many reasons, but I think one of them is that it helps me stop rumination and what some refer to as default mode thinking. Don't get me wrong - I don't float above the floor when I meditate, and the moments of non-rumination (or present awareness) are extremely fleeting. But, somehow, I feel better having done it.

It has been a bit of a journey for me, and I believe it will continue to be. I enjoy reading others' thoughts on the contemplative traditions because I think reading a new perspective helps me get a deeper understanding of what is attractive about this way of thinking. One author describes Buddhist thought as being in the Matrix (blue pill, red pill). It forces you to learn that our current view of reality is heavily shaped and created by a whole bunch of mental constructs that may or may not have any real justifications. Realizing this can be liberating.

Anyway, that all may be way too philosophical for this forum! But if any of the above makes any modicum of sense to you, I can suggest a few things to read. I don't believe there is any one "bible" that fully elucidates all these concepts perfectly, but I think much of what I have read has hinted at various truths that have helped me deal with every day life.

A fun and pretty easy one to start with is called "Ten Percent Happier" by Dan Harris. I also really like a book called "Why Buddishm is True" Can't remember the author, but he is a professor at Princeton. I don't love the title (it feels too religious and can be off-putting, but the book is great). I have several others that were great. Feel free to DM me if you want more recommendations.
Thank you very much for the detailed reply. Fantastic!

I read When Things Fall Apart by Chaudron and found it a helpful read. For the depression it was really useful to just sit with it and move forward. But lately with the panic and heart I realized I was out of my league. For me to take an SSRI meant I had to surrender and realize I was not smart enough to figure this out on my own without the SSRI or benzo (initially). Eye opening experience. Had to check my pride and ego.

I will check out the references you provided and thanks for the offer to PM. I appreciate you @Fortunate .
 
For me the ssri” seem” to give me the ability to tolerate higher levels of testosterone also
Oh sh*t. I should not have read that. Thanks alot. :)

Repeating to myself....do not look at the bottom shelf of fridge door, do not....
 
First, I should say that I come from a Judeo-Christian background and have no formal training in theology or philosophy. But, over the last several years, I have done quite a bit of reading in Eastern approaches to understanding the human condition, and have found it pretty helpful.

I would say Vipassana concept has been useful. By grasping the concepts behind this style of thinking, you have the potential to reduce self-inflicted suffering. One of the things I have read is that some believe that Pain x Resistance = Suffering. We can't eliminate painful stimuli. It's part of life. But, by reducing resistance, or just by accepting certain things about the world and ourselves, we can reduce our suffering.

An example is the Second Arrow phenomenon. I don't remember the exact story, but has to do with a monk shot by an arrow. After being shot, he began to worry about the wound getting infected, bleeding and all sorts of consequences. Obviously, getting shot by an arrow hurts and can cause problems, but it was the worry itself that made the experience so painful. I think the lesson here is that equanimity, even towards your own human experience, can help you suffer less.

I have played with insight meditation as well as Transcendental Meditation (TM). They are different schools of thought with different potential benefits, but I believe there are overlapping benefits to the two techniques. I was formally trained in TM, and found it a nice technique, but got a bit turned off by the organization itself (I can expand if you want). Currently, I find myself using both techniques periodically. I can't say exactly what keeps drawing me to meditate, but I find myself wanting to do it on a regular basis. There are probably many reasons, but I think one of them is that it helps me stop rumination and what some refer to as default mode thinking. Don't get me wrong - I don't float above the floor when I meditate, and the moments of non-rumination (or present awareness) are extremely fleeting. But, somehow, I feel better having done it.

It has been a bit of a journey for me, and I believe it will continue to be. I enjoy reading others' thoughts on the contemplative traditions because I think reading a new perspective helps me get a deeper understanding of what is attractive about this way of thinking. One author describes Buddhist thought as being in the Matrix (blue pill, red pill). It forces you to learn that our current view of reality is heavily shaped and created by a whole bunch of mental constructs that may or may not have any real justifications. Realizing this can be liberating.

Anyway, that all may be way too philosophical for this forum! But if any of the above makes any modicum of sense to you, I can suggest a few things to read. I don't believe there is any one "bible" that fully elucidates all these concepts perfectly, but I think much of what I have read has hinted at various truths that have helped me deal with every day life.

A fun and pretty easy one to start with is called "Ten Percent Happier" by Dan Harris. I also really like a book called "Why Buddishm is True" Can't remember the author, but he is a professor at Princeton. I don't love the title (it feels too religious and can be off-putting, but the book is great). I have several others that were great. Feel free to DM me if you want more recommendations.
Would give this more than one like and some heart emojis if the system allowed. Thanks again Brother.

-------<<<@
 
This is consistent with the idea that something about excessively high or excessively stable levels of T and related hormones is numbing or depressing. The forms of TRT most likely to avoid these symptoms IMO are:

  • Low/moderate doses of cypionate or enanthate injected once weekly
  • Low/moderate doses of cream. Once daily application might be preferable to twice daily.
  • Low/moderate doses of propionate injected ED or EOD
  • Jatenzo and similar orals
  • Natesto


It is hard to say. I don't know if you have maxed out your SSRI-induced propensity to depression already or if it can worsen further with additional use. I have done the same thing you did recently where I took a few doses of SSRI when I was at a low point and then changed my mind. I am biased against using them for depression and I am grateful that I managed to get through some tough spots without them. Whichever decision you make will be understandable though.
It’s also funny you say that. I just switched to once a week injection. 100mg per week. I dont feel terrible. But I take my shot on Thursday. Start to feel off on Friday then mood kinda sucks sat Sunday. Then I progressively start to feel better. only been on for two weeks. But that’s what’s happened so far.
 
It’s also funny you say that. I just switched to once a week injection. 100mg per week. I dont feel terrible. But I take my shot on Thursday. Start to feel off on Friday then mood kinda sucks sat Sunday. Then I progressively start to feel better. only been on for two weeks. But that’s what’s happened so far.
Well 3 years ago I was running 250mg once a week shot and did that for 3 years pretty much without coming off. Felt more or less myself, hard to say, but since I didn't look for a change I believe it felt OK during that time, don't remember quite well but I was't focused like now on longevity, wellness and cognitive functions. Everyone I knew was running the same 250mg/week with once a week injections. But this was more of a sports orientated TRT if I can say that and def my levels were high. Shame I got no bloodwork to see the actual T levels. Give it a bit more time and see what happens and how you feel. If you feel the same then imo pinning once a week is def more acceptable then doing more frequent injections considering all blood markers and sides are under control.
 
This is consistent with the idea that something about excessively high or excessively stable levels of T and related hormones is numbing or depressing. The forms of TRT most likely to avoid these symptoms IMO are:

  • Low/moderate doses of cypionate or enanthate injected once weekly
  • Low/moderate doses of cream. Once daily application might be preferable to twice daily.
  • Low/moderate doses of propionate injected ED or EOD
  • Jatenzo and similar orals
  • Natesto


It is hard to say. I don't know if you have maxed out your SSRI-induced propensity to depression already or if it can worsen further with additional use. I have done the same thing you did recently where I took a few doses of SSRI when I was at a low point and then changed my mind. I am biased against using them for depression and I am grateful that I managed to get through some tough spots without them. Whichever decision you make will be understandable though.
What’s your propionate dose and how long have you been doing this for? What side effects are you having from doing this?
 
What’s your propionate dose and how long have you been doing this for? What side effects are you having from doing this?
I'm up to 10 mg daily now and will probably continue working my way up until I start feeling worse. I only switched to propionate a couple weeks ago and have been increasing the dose day by day so it is much too early to make judgments. You asked though so here goes:

Currently, the only any side effects that I can attribute to TRT right now are acne on my chest and some hair loss. Hair loss might be reduced compared to equivalent dose of cypionate. Generally I've just been feeling gradually better as the cypionate washes out. Feeling mentally sharper, good mood, good energy. I was having serious trouble with word recall on cypionate. Water retention has also disappeared as cypionate left my system. Libido is still meh so far.
 
I'm up to 10 mg daily now and will probably continue working my way up until I start feeling worse. I only switched to propionate a couple weeks ago and have been increasing the dose day by day so it is much too early to make judgments. You asked though so here goes:

Currently, the only any side effects that I can attribute to TRT right now are acne on my chest and some hair loss. Hair loss might be reduced compared to equivalent dose of cypionate. Generally I've just been feeling gradually better as the cypionate washes out. Feeling mentally sharper, good mood, good energy. I was having serious trouble with word recall on cypionate. Water retention has also disappeared as cypionate left my system. Libido is still meh so far.
Sorry if I missed it. But what do you personally think is the reason cyp gives you issues ? I’ve heard a few guys over the years do well on prop first few weeks till the cyp/ent washed out. Then are on a roller coaster ride.
not saying that’s going to happen to you and I hope it works out.
 
Sorry if I missed it. But what do you personally think is the reason cyp gives you issues ? I’ve heard a few guys over the years do well on prop first few weeks till the cyp/ent washed out. Then are on a roller coaster ride.
not saying that’s going to happen to you and I hope it works out.
I think there are a few possibilities (pure speculation):
  1. Constantly high testosterone causes some kind of deleterious effects in the brain that are relieved by periods of lower testosterone. This might be mediated by oxidative stress or accumulation of some noxious downstream byproducts.
  2. Variability in levels might be needed for receptors to remain sensitive in the brain.
  3. HPTA shutdown is not a binary on/off switch but a continuum. Periods of reduced testosterone and E2 may allow for some tiny blips of HPTA activity that improve well-being, perhaps via neurosteroids. I've seen at least one claim of higher pregnenolone on propionate for example.
  4. Higher DHT/E2 ratio on propionate may be preferable for some people.
I would be interested to know if those who found propionate to be a rollercoaster had tried it SC, because I had that same complaint with IM prop and it is completely gone with SC.
 
I think there are a few possibilities (pure speculation):
  1. Constantly high testosterone causes some kind of deleterious effects in the brain that are relieved by periods of lower testosterone. This might be mediated by oxidative stress or accumulation of some noxious downstream byproducts.
  2. Variability in levels might be needed for receptors to remain sensitive in the brain.
  3. HPTA shutdown is not a binary on/off switch but a continuum. Periods of reduced testosterone and E2 may allow for some tiny blips of HPTA activity that improve well-being, perhaps via neurosteroids. I've seen at least one claim of higher pregnenolone on propionate for example.
  4. Higher DHT/E2 ratio on propionate may be preferable for some people.
I would be interested to know if those who found propionate to be a rollercoaster had tried it SC, because I had that same complaint with IM prop and it is completely gone with SC.
I share some of the same thoughts and feelings as you. And it seems guys that struggle with trt Have had anxiety and depression in the past or tend to be over thinkers. . so is it actually the trt exacerbating the symptoms. or the way people wired like us overthink trt. I know I’ve had some strange physical symptoms on trt that I think “no way this is in my head “ but who knows.
I do feel like I also have trouble with word recall. And even getting my thoughts down to paper is so hard for me now. But how can we be sure it has anything to do with trt. I feel like guys like me are way to hyper aware of everything going on when I’m taking medication. And do believe some times it’s purely me over analyzing my issues.
 
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@FunkOdyssey whats your take away from these study. Might be better ones. But these 2 are talking about the possibility of restoring hpa. That I think is my biggest problem and one of the reasons I tried ssri with trt.
This was the basis for the Dr. Mariano low-dose SSRI craze and I do think it can work for this purpose. The SSRI seems to act like an "adaptogen", improving the resistance to stress and normalizing HPA function. However, the benefits are part of a larger package that includes emotional blunting, apathy, increased susceptibility to depression, personality changes, sexual dysfunction / risk of PSSD, weight gain, osteoporosis, and other negative consequences too numerous to list.

Just sign on the dotted line for relief from an overactive HPA axis:
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